Assessment of molecular markers of anti-malarial drug resistance among children participating in a therapeutic efficacy study in western Kenya.

摘要: Anti-malarial drug resistance remains a major threat to global malaria control efforts. In Africa, Plasmodium falciparum susceptible artemisinin-based combination therapy (ACT), but the emergence of resistant parasites in multiple countries Southeast Asia and concerns over and/or spread Africa warrants continuous monitoring. The World Health Organization recommends that surveillance for molecular markers be included within therapeutic efficacy studies (TES). current study assessed associated with Artemether−lumefantrine (AL) Dihydroartemisinin−piperaquine (DP) from samples collected children aged 6–59 months enrolled TES conducted Siaya County, western Kenya 2016 2017. Three hundred twenty-three pre-treatment (day-0) 110 at day recurrent parasitaemia (up 42) were tested presence Pfk13 propeller domain, Pfmdr1 Pfcrt genes by Sanger sequencing. Additionally, Pfpm2 gene copy number was real-time polymerase chain reaction. No mutations previously artemisinin detected region. However, other non-synonymous region detected. most common mutation found on day-0 recurrence multidrug marker codon 184F. Very few (< 5%). Within DP arm, all recrudescent cases (8 sample pairs) had single copy. None associations between observed treatment outcomes statistically significant. results indicate absence parasite this area very high proportion wild-type Pfcrt. Although frequency 184F these samples, association failure did not reach statistical significance. As artemisinin-resistant possibility, continued monitoring ACT is needed complement clinical data inform policy malaria-endemic regions.